Organization
JONSSON COMPREHENSIVE CANCER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA GANZ M.D. (DIRECTOR)
(310) 206-1401
Entity
Organization
Contact information
Practice address
650 CHARLES YOUNG DR S, ROOM A2-125 CHS, LOS ANGELES, CA 90095-0001
(310) 825-8711
(310) 206-3566
Mailing address
650 CHARLES YOUNG DR S, ROOM A2-125 CHS, LOS ANGELES, CA 90095-0001
(310) 825-8711
(310) 206-3566
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC000060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002066
AMERICAN BOARD OF GENETIC COUNSELING
—
01
—
GC000060
GENETIC COUNSELOR LICENSE
CA
Enumeration date
10/27/2014
Last updated
10/27/2014
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